| NPI | 1447635701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 17283) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 101YA0400X) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2015-12-15 |